A Look at the Ruling in Support of Obamacare

WHAT DOES THE RULING MEAN TO ME? The Supreme Court decision upholding President Barack Obama's health care law affects nearly every American. The law tells almost everyone they must have health coverage and guarantees it will be available to them even if they are already ill or need hugelyexpensive care. It helps the poor and many middle-class peopleafford coverage.

WHAT THE JUSTICES SAID The high court upheld almost all of the law, including the mostdisputed part: the mandate that virtually all Americans have healthinsurance or pay a fine. The court said that fine is essentially atax, and that's why the government has the power to impose it. The ruling limited the law's plan to expand the Medicaidinsurance program for the poor, a joint effort of the federalgovernment and states. It says the U.S. government cannot withholda state's entire Medicaid allotment if it doesn't participate inthe expansion. Chief Justice John Roberts sided with the court's four liberaljustices - Stephen Breyer, Ruth Bader Ginsburg, Elena Kagan andSonia Sotomayor - to form the 5-4 majority.

HUGE POLITICAL IMPACT The court upheld Obama's signature legislative achievement.Final word from the court amplifies the most polarizing issue ofhis re-election campaign against Republican Mitt Romney. GOP lawmakers and Romney have promised to repeal the law if they are in power after the November election.

WHAT NOW? The 2010 health care law will keep taking effect. It's expectedto bring coverage to about 30 million uninsured people. Overall,more than 9 in 10 eligible Americans will be covered. Some parts are already in effect: Young adults can stay on theirparents' insurance up to age 26. Insurers can't deny coverage tochildren with health problems. Limits on how much policies will payout to each person over a lifetime are eliminated. Hundreds ofolder people already are saving money through improved Medicareprescription benefits. And co-payments for preventive care for allages have been eliminated.

WHAT'S NEXT? Starting in 2014, almost everyone will be required to be insuredor pay a fine. There are subsidies to help people who can't affordcoverage. Most employers will face fines if they don't offercoverage for their workers. Newly created insurance markets willmake it easier for individuals and small businesses to buyaffordable coverage. And Medicaid will be expanded to cover morelow-income people. Insurers will be prohibited from denying coverage to people withmedical problems or charging those people more. They won't be ableto charge women more, either. During the transition to 2014, aspecial program for people with pre-existing health problems helpsthese people get coverage. An assortment of tax increases, health industry fees andMedicare cuts will help pay for the changes.

STILL, NOT EVERYONE WILL BE COVERED An estimated 26 million people will remain without coverage oncethe law is fully implemented, including illegal immigrants, peoplewho don't sign up and choose to face the fines instead, and thosewho can't afford it even with the subsidies. That number could behigher, depending on whether any states refuse the Medicaidexpansion.

THE TAXING TRUTH When the law was before Congress, Obama and Democrats avoided calling its penalty for going uninsured a "tax." But theadministration argued before the Supreme Court that the law wasconstitutional as a federal tax. The court rejected two other Obamaadministration arguments for the law but accepted the tax one. In 2016, after the law is fully in place, about 4 million peoplewill pay the penalty to the Internal Revenue Service for beinguninsured, the Congressional Budget Office has estimated. Theywould pay $695 per uninsured adult or 2.5 percent of family income,up to $12,500 per year. The IRS can't prosecute violators or place liens against them,however. Its only enforcement option may be withholding money fromrefunds.

WHAT ARE REPUBLICANS SAYING? "Obamacare was bad law yesterday. It's bad law today," Romneysaid after the ruling. The Republican-led House already has voted for repeal but can'tpush it forward so long as Obama's in the White House and Democrats lead the Senate - making the November elections crucial. Senate Republican Leader Mitch McConnell called the courtdecision "a fresh start on the road to repeal."

OBAMA'S REACTION Obama says the decision upholds the fundamental principle thatin the wealthiest nation on earth, no one should be ruinedfinancially by an illness or accident. He called it "a victory for people all over this country whoselives will be more secure because of this law."

ABOUT THAT MANDATE Many parts of the law have proven popular. But the insurancemandate is widely disliked. Each time AP has asked in polls, more than 8 in 10 Americanshave said the government should not have the right to requireeveryone to buy health insurance. The public also has tilted against the law as a whole over thetwo years since it was passed. About half opposed it and a thirdwere in favor in an AP-GfK poll shortly before the Supreme Courtruled.

Copyright 2015 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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